University of Iowa Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242, USA.
Am Fam Physician. 2010 Mar 15;81(6):735-9.
Although it is important to begin the evaluation of generalized rash with an inclusive differential diagnosis, the possibilities must be narrowed down by taking a focused history and looking for key clinical features of the rash. Part I of this two-part article lists the common, uncommon, and rare causes of generalized rashes. In part II, the clinical features that help distinguish these rashes are described. These features include key elements of the history (e.g., travel, environmental exposures, personal or family history of atopy); characteristics of individual lesions, such as color, size, shape, and scale; areas of involvement and sparing, with particular attention to palms, soles, face, nails, sun-exposed areas, and extensor and flexor surfaces of extremities; pruritic or painful lesions; systemic symptoms, especially fever; and dermatologic signs, such as blanching, and the Koebner phenomenon.
虽然在评估全身性皮疹时，采用包容性鉴别诊断很重要，但通过关注病史并寻找皮疹的关键临床特征，可以将可能性缩小范围。本文分为两部分，第一部分列出了全身性皮疹的常见、不常见和罕见原因。在第二部分中，描述了有助于区分这些皮疹的临床特征。这些特征包括病史的关键要素（例如，旅行、环境暴露、特应性的个人或家族史）；单个病变的特征，如颜色、大小、形状和鳞屑；受累和未受累的区域，特别注意手掌、足底、面部、指甲、暴露于阳光的区域以及四肢的伸肌和屈肌表面；瘙痒或疼痛的病变；全身症状，特别是发热；以及皮肤科体征，如褪色和同形反应。
